Hirsutism physical examination

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Hirsutism Microchapters

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Associate Editor(s)-in-Chief: ; Rasam Hajiannasab M.D.[2], Ahmed Younes M.B.B.CH [3]

Overview

Patients with hirsutism usually appear normal and in no acute distress. The degree of hirsutism can be estimated using the Ferriman-Gallwey score.

Physical Examination

General

Patients with hirsutism usually appear normal and in no acute distress. The degree of hirsutism can be estimated using the Ferriman-Gallwey score.[1]

Appearance

  • Patients with hirsutism usually appear normal and in no acute distress.

Skin

  • generalized increase in growth of the hair on all of the body (hypertrichosis).[1]
  • The skin of the abdomen may show striae in the cases of Cushing syndrome.
Upper lip 0-4
Chin 0-4
Chest 0-4
Leg 0-4
Thigh 0-4
Upper arm 0-4
Forearm 0-4
Upper back 0-4
Lower back 0-4
Upper abdomen 0-4
Lower abdomen 0-4
A patient with Cushing disease and hirsutism - By Ozlem Celik, Mutlu Niyazoglu, Hikmet Soylu and Pinar Kadioglu - http://mrmjournal.biomedcentral.com/articles/10.1186/2049-6958-7-26, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=47877333

Neck

  • The neck is usually supple without any masses.

Lungs

  • The lungs are usually clear to auscultation.

Abdomen

  • Inspection may show central obesity if Cushing syndrome is present.[2]
  • Palpation of the abdomen may reveal masses in the iliac fossae if PCO is the cause of hirsutism.

Heart

  • Auscultation of the heart reveals normal S1, S2, with no rubs, gallops, or murmurs.

Extremities

  • The extremities may show wasting in the cases of Cushing syndrome.

Neurologic

  • Patient is usually oriented to time, person, and place with average motor and sensory functions.

References

  1. 1.0 1.1 Rosenfield, Robert L. (2005). "Hirsutism". New England Journal of Medicine. 353 (24): 2578–2588. doi:10.1056/NEJMcp033496. ISSN 0028-4793.
  2. Hunter MH, Carek PJ (2003). "Evaluation and treatment of women with hirsutism". Am Fam Physician. 67 (12): 2565–72. PMID 12825846.